| NPI | 1154474104 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK LOES Director Of Operations 509-969-0092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: WA RTF-1064) |
| Additional Taxonomies | 251B00000X Case Management (Licence: WA RTF-1064) |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: WA RTF-1064) | |
| 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children (Licence: WA RTF-1064) | |
| Enumeration Date | 2007-01-20 |
| Last Update Date | 2022-08-23 |